Introduction The NHS Bowel Cancer Screening Programme (BCSP) in England has demonstrated high quality colonoscopy . Bowel Cancer Screening in Wales began in October 2008. We report results of first 3 years of screening in a single Welsh centre. Comparison is made with results from the English BSCP.
Methods Data was collected prospectively for participants undergoing FOBt testing and colonoscopy or flexible sigmoidoscopy between October 2009 and December 2011 in Cardiff and the Vale of Glamorgan. Quality indicators were calculated where appropriate. Adenomas were confirmed after correlation with histopathology reports. with no adenoma double counted.
Results 42630 faecal occult blood test kits were returned from 91414 sent (46.6%), leading to 933 colonoscopies (795 index) and 82 flexible sigmoidoscopies (not index but mostly for therapeutic procedures) undertaken by four accredited screeners. Mean ADR per colonoscopist was 54.1%, mean number of adenomas per procedure (MAP) was 1.24 and the mean adenomas per positive procedure (MAP+) was 2.3, with a mean polyp retrieval rate of 98%. Mean midazolam dose was 2 mg (range 0.5–4 mg) and fentanyl 50mcg (range 25–100 cmg). Hyoscine n-butyl bromide was used in 34.5% of cases, with no increased ADR (p = 1.000). Only 2% of patients reported severe discomfort. Bowel cancer was detected in 69 individuals; a positive predictive value of colonoscopy (after positive FOBt) of 8.7%.
Conclusion Our centre is providing high quality colonoscopy, with statistically significant higher rates of adenoma detection in both the index and prevalent rounds of screening colonoscopies compared to data from the English BCSP, and a low rate of adverse events given an increased need for endoscopic therapy. Measures of total adenoma detection (MAP and MAP+) also compare favourably. Further information is required to ascertain the clinical outcome measure of the missed cancer rate following a screening colonoscopy within the BSCP across the UK.
Disclosure of Interest None Declared.
Lee TJW et al. Colonoscopy quality measures: experience from the NHS Bowel Cancer Screening Programme. Gut 2011; 61: 1050–7
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